COVID-19 may trigger autoimmune disease myasthenia gravis which leads to extreme muscle weakness and fatigue

COVID-19 first showed up in Wuhan, China as a respiratory illness characterised by fever, cough and shortness of breath. However, soon it was apparent that the disease affects many organs of the body including the heart, kidneys and skin. It was also suggested to trigger new-onset diabetes and cause a condition called multisystem inflammatory syndrome in children. Now, a study involving three patients in Italy indicates that the disease could also trigger an autoimmune condition called myasthenia gravis. The study was published in the journal Annals of Internal Medicine. Myasthenia gravis is a neuromuscular disease that leads to muscle weakness that worsens after physical activity and improves on taking rest. The condition affects muscles that control swallowing, eye movements, talking, chewing and facial expressions. The condition affects about 20 people in every 100,000 in the world. The case reports The study mentioned above involved three COVID-19 patients - a 71-year-old woman, and two men who were 64 and 68 years of age. The 64-year-old man had a fever of about 102.2 degrees Fahrenheit for four days. After five days of fever, he started to show symptoms of myasthenia gravis including double vision and muscle fatigue. He also showed a 57 percent reduction in nerve stimulation in the face and was confirmed positive for myasthenia gravis through a blood test. The 68-year-old man had a fever as high as 101.8 degrees Fahrenheit for a week. He started to show myasthenia gravis symptoms including double vision, swallowing difficulty and muscle fatigue after seven days of fever onset. This man also showed the presence of acetylcholine receptor antibodies in his blood - an indicator of myasthenia gravis. The woman had a fever of about 101.48 degrees Fahrenheit for about six days. She started to show symptoms like hypophonia (soft speech due to lack of muscle coordination), double vision and droopy eyelids after five days of COVID-19 symptoms. She also developed swallowing difficulty and respiratory failure and needed ventilation for a while. Additionally, the woman had high levels of serum acetylcholine receptor antibodies. Not the only condition Symptoms like headache, confusion, dizziness, and difficulty concentrating have already been seen in COVID-19 patients. A Lancet study reported a case of Guillain-Barré syndrome in a 61-year-old coronavirus patient who had just returned from Wuhan, China. Guillain-Barré syndrome is yet another autoimmune disorder in which a person’s immune system starts to attack their peripheral nervous system - nerves outside the brain and spinal cord. The condition causes symptoms such as muscle weakness, difficulty swallowing, difficulty using eye muscles, vision problems, severe pain that worsens at night, coordination problems and pins and needle sensations in the hands and feet. In fact, most viruses replicate inside the brain and affect the brain in one or the other way when they cause infection. For example, viruses like enterovirus and mumps virus cause acute meningitis; herpes simplex, rabies and arbovirus cause encephalitis. The diseases can be acute (short-lived) or it can be chronic (persists for long). It may occur due to replication of the virus or it can occur due to the immune system attacking the brain cells. It is worth noting that this is just a case study involving three patients. More studies would be needed to confirm the findings. For more information on the effects of COVID-19 on the nervous system, read our article on Neurological symptoms of COVID-19 Health articles in Firstpost are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.